Incidence and natural history of very early-onset inflammatory bowel disease in Scotland: national and regional cohort studies

Background: Very early-onset inflammatory bowel disease (VEOIBD) (diagnosed under 6 years of age) has attracted considerable attention in recent years, with monogenic forms providing insight into immune dysregulation. However, the majority of VEOIBD patients have a classical polygenic phenotype and a similar disease course to older children. Methods: The study sought to assess the incidence trends of VEOIBD in Scotland from 1981 to 2014 and to describe the natural history, phenotype, and treatment burden of VEOIBD in a regional cohort from South-East Scotland (1997-2021). Results: Nationally, 128 (8.1%) of 1567 incident pediatric inflammatory bowel disease (IBD) patients (<16 years of age at diagnosis) were VEOIBD; 10 (8%) of 128 were diagnosed <2 years of age. The incidence of VEOIBD rose from 0.64 per 100 000 per year (1981-1985) to 2.73 per 100 000 per year (2011-2014) (P = .002), an incidence rate ratio of 4.3 (95% confidence interval, 2.4-8.3). The average annual percentage change was 3.9% (95% confidence interval, 2.1%-5.7%) (P < .05). Crohn’s disease was the most common subtype (63%); the median age at diagnosis was 4.4 years. The regional cohort (n = 46) had a median follow-up of 11.9 years. Crohn’s disease cases presented with isolated colonic involvement in 47%, with pancolitis present in 64% of ulcerative colitis cases. Treatment exposures included immunosuppression (76%), corticosteroids (67%), and anti-tumor necrosis factor therapies (50%). A total of 11% were on no IBD-specific therapy at last follow-up, 11% required surgery and no patient had a diagnosis of monogenic IBD, cancer, or death. Conclusions: Scotland has a high incidence of VEOIBD, with monogenic IBD exceptionally rare. Although VEOIBD disease burden is high, treatment outcomes are broadly similar to those diagnosed later in childhood based on previous studies

Comparative Efficiency of HEP Codes Across Languages and Architectures

Recently, interest in measuring and improving the energy (and carbon) efficiency of computation in HEP, and elsewhere, has grown significantly. Measurements have been, and continue to be, made of the efficiency of various computational architectures in standardised benchmarks, but those benchmarks tend to compare only implementations in single programming languages. Similarly, comparisons of the efficiency of various languages tend to focus on a single architecture, although it is the case that some abstractions in a given language can match specific architectural choices (in, say, memory ordering strictness) better than others. The existence of the JetReconstruction.jl project, implementing a subset of the FastJet C++ code’s functionality in performant Julia, allows us to usefully compare how the relative efficiencies of implementations in the two languages are influenced by the architecture they are executed on. We report on the results of comparing benchmarks on these codes, and others, on AMD64 and various aarch64 implementations, amongst others

Embedding rewilding in policy: Perspectives on overcoming barriers and unlocking opportunities

Rewilding initiatives are increasing in number across Europe and the UK in response to a growing awareness of substantial nature depletion, despite a lack of policy, guidance and legislation. Ongoing transformations of UK environmental policies offer a ‘policy window’ in which rewilding could become established as a key strategy for nature recovery. Here, we present the results of discussion sessions held as part of a British Ecological Society Policy Training workshop. A total of 46 participants, academics, practitioners and young people interested in rewilding attended. Our discussion focused on three pre‐determined thematic discussion sessions: (1) barriers to rewilding and trade‐offs; (2) species reintroductions; (3) facilitating rewilding in policy. Using thematic analysis, four emerging cross‐cutting themes were identified from our workshop discussions: (a) environmental stewardship & public engagement, (b) cross‐policy approaches, (c) incentivising rewilding and (d) an evidence base for rewilding. Policy Implications. Given the UK's considerable biodiversity loss, restoring ecosystem processes and function on a large scale is increasingly urgent, and operationalising rewilding through supportive environmental policy structures should be a key priority for government

Hair removal and lesion segmentation of dermoscopic images for classification of skin cancer using deep neural networks

Skin cancer is a prevalent health issue worldwide. Therefore, early detection through automated deep learning systems is crucial for saving lives. Hair presence in dermoscopic image presents diagnostic challenges by obscuring lesion features and complicating analysis due to variations in hair characteristics (density, color, and distribution), which can lead to diagnostic errors. In this work, a new and comprehensive approach is introduced to enhance the automatic classification of skin lesions. We propose an Efficient Hair Removal (EHR) technique that combines a Deep Residual U-Net with the TELEA inpainting algorithm, effectively eliminating hair artifacts from dermoscopic images. For precise lesion delineation, a Deep Residual U-Net model for skin lesion segmentation is also employed. The ISIC2019 dataset is used for skin lesion classification. Our approach progresses through five experimental stages, each building upon the previous. Starting with dataset balancing, which improved classification accuracy by 5%, we then applied our EHR framework, further boosting accuracy by 2.53%. The integration of skin lesion segmentation contributed to an additional 1.5% improvement. In the last, we use modified DenseNet169 architecture, which achieves a top accuracy of 97.74% on the ISIC2019 dataset, outperforming existing techniques. For lesion segmentation, Deep Residual U-Net achieved good results on the ISIC2018 dataset, with an Intersection over Union (IoU) of 0.8981 and a Dice Similarity Score (DSC) of 0.946

A Review of Recent Developments in Energy Storage and Drive Systems for Self-powered Electric Rail Vehicles

Building on two publications from 2019, this report reviews developments that have taken place over the last six years in energy storage and electrical drive systems for self-powered railway, light-rail, and tramway vehicles. These can incorporate electrical batteries, supercapacitors, hydrogen fuel cells, electromagnetic storage systems, and mechanical devices such as flywheels, together with control and energy management sub-systems. As in the earlier reports, each type of system is discussed separately, but some emphasis is given to developments in hybrid systems involving combinations of power sources and to associated design optimisation issues. Railways provide an important application area for short-term energy storage, especially in the context of the growing interest in discontinuous electrification schemes. Published reports and papers that describe recent operating experience and problems encountered in the use of newly designed and converted vehicles provide valuable information, and several of these are referenced. Promising research and development work is also summarised, and an attempt is made to predict future trends. Four appendices provide more detailed information about recent rail applications and also current proposals

The just-follow conversation test: a quick, reproducible measure of subjective intelligibility that is not sensitive to amplification

Objective: Listening in a conversation has numerous demands not addressed by traditional speech-intelligibility tests. We here examine the utility of an alternative way to assess conversational listening, the just-follow conversation (JFC) test, namely its reproducibility and sensitivity to stimulus changes, as well as what it can tell us about conversational demands. Design: Participants repeatedly adjusted the overall level of one monologue, one dialogue and two simultaneous monologues in the front hemifield until they could just follow the speech. Speech was presented in surrounding fixed-level café and same-spectrum noise backgrounds. Study sample: Fifty-four adults, including 27 bilateral hearing-aid (HA) users, participated. HA users adjusted aided and unaided in separate blocks; non-users repeated each condition to evaluate reproducibility. Results: JFCs were greater for dialogues than monologues, but not greater for two simultaneous monologues than dialogues. Individual JFCs correlated with self-reported speech understanding as well as pure-tone threshold averages. Aiding did not have a significant effect on results. Measures of reproducibility were comparable to more traditional speech-intelligibility tests. Conclusion: The current results show that the JFC test is a relatively quick, repeatable measure that invokes both subjective and objective components of speech understanding, but it may be of limited use in evaluating amplification

Clinical case summary and presentation: a pilot study to address the gap and improve medical students’ performance in bedside teaching

Introduction: Bedside teaching is a well-known clinical teaching method that provides medical students with a real-life experience and patient interaction. As future doctors, medical students need to learn not only how to take a history and perform an examination but also how to present their findings. Providing a summary of a clinical case and presenting it back is an important non-technical skill that is often overlooked during bedside teaching. Objective: The aim of this prospective pilot study was to evaluate the outcome of teaching undergraduate medical students how to provide a verbal case summary and presentation. Methods: A total of 45 fourth-year medical students from the University of Glasgow (UOG) completed a pre-teaching survey in two groups: 25 students (group A) attended small group bedside teaching in a cardiac surgery ward only, while 20 students (group B) attended a large group tutorial prior to the bedside session. During the bedside sessions, each student undertook a history and examination and then provided a clinical summary of their encounter to the supervisor. The student and the supervisor then completed a post-teaching assessment. Results: Of the 45 students, 33 (73%) were “somewhat confident” with their presentation skills; only 28 (62%) had received previous teaching about clinical case summary, while 23 (51%) did not know which information to include or which to omit when summarising. The supervisor’s assessment demonstrated that 16 (84%) students’ presentations out of 19 in group A were “very good” or “excellent” in terms of being in chronological order, 11 (58%) in using medical terms, 10 (53%) in being concise, 15 (79%) in being clear, and 13 (68%) in being comprehensive. These numbers increased in group B to 18 (90%) out of 20, 16 (80%), 13 (65%), 16 (80%), and 15 (75%), respectively, with the greatest improvement being increased use of medical terms. Using the students' self-assessment, 20 (80%) out of 25 students in group A evaluated their case summary and presentation as being in chronological order, 20 (80%) used medical terms, 15 (60%) were concise, 15 (60%) were clear, and 12 (48%) were comprehensive. In group B, the evaluation of these parameters changed to 15 (75%) out of 20, 15 (75%), eight (40%), 11 (55%) and 13 (65%), respectively. The greatest reduction occurred in the conciseness of the presentations, while there was an increase in the comprehensiveness parameter. All students from group B evaluated both the tutorial and the bedside session positively across all parameters; 14 (65%) rated their confidence in providing a case summary and presentation after the teaching session between 4 and 5, while 18 (90%) expected their verbal communication skills to improve on a scale of 4-5. Conclusion: Group B showed improved performance in all parameters according to the supervisor’s assessment, whereas group A students rated their own performance higher than that of group B. More focused and structured teaching about clinical case summary and presentation is required to address the gap in undergraduate medical education

Moving Beyond a Rule-Book Notion of Grammar with Metaphor-Led Pedagogy

The importance for Teaching English to Speakers of Other Languages (TESOL) pre-and in-service language teachers to have Language Awareness (LA) and to be able to apply this knowledge to their teaching is well recognised to be a key curriculum goal (Marr and English, 2019). Yet, many novice TESOL teachers find applying their knowledge of language systems to dynamic teaching situations in a meaningful way challenging and tend to resort to a reductive rule-based approach to teaching about language. By adopting an enabling approach to understanding language use that correlates with our embodied and metaphorical understanding of the world around us, I show how we can use this feature of language and languaging to build more meaningful bridges with our young and adult multilingual learners during language focused activities in the classroom. This approach shifts the learners’ attention to the meaning making process itself, resulting in a deeper understanding of the grammatical concepts

Angular analysis of B0 → K*0e+e− decays

An angular analysis of B0→ K*0e+e− decays is presented using proton-proton collision data collected by the LHCb experiment at centre-of-mass energies of 7, 8 and 13 TeV, corresponding to an integrated luminosity of 9 fb−1. The analysis is performed in the region of the dilepton invariant mass squared of 1.1–6.0 GeV2/c4. In addition, a test of lepton flavour universality is performed by comparing the obtained angular observables with those measured in B0→ K*0μ+μ− decays. In general, the angular observables are found to be consistent with the Standard Model expectations as well as with global analyses of other b → sℓ+ℓ− processes, where ℓ is either a muon or an electron. No sign of lepton-flavour-violating effects is observed

Inhibition of placental trophoblast fusion by guanylate-binding protein 5

Syncytin-1 and Syncytin-2 are envelope glycoproteins encoded by human endogenous retroviruses that have been exapted for the fusion of cytotrophoblast cells into syncytiotrophoblasts during placental development. Pregnancy complications like preeclampsia are associated with altered expression of interferon-stimulated genes, including guanylate-binding protein 5 (GBP5). Here, we show that misdirected antiviral activity of GBP5 impairs processing and activation of Syncytin-1. In contrast, the proteolytic activation of Syncytin-2 is not affected by GBP5, and its fusogenic activity is only modestly reduced. Mechanistic analyses revealed that Syncytin-1 is mainly cleaved by the GBP5 target furin, whereas Syncytin-2 is also efficiently processed by the proprotein convertase subtilisin/kexin type 7 (PCSK7) and thus resistant to GBP5-mediated restriction. Mutational analyses mapped PCSK7 processing of Syncytin-2 to a leucine residue upstream of the polybasic cleavage site. In summary, we identified an innate immune mechanism that impairs the activity of a co-opted endogenous retroviral envelope protein during pregnancy and may potentially contribute to the pathogenesis of pregnancy disorders